telehealth service

(4) Definitions For purposes of this subsection: (A) Distant site The term “distant site” means the site at which the physician or practitioner is located at the time the service is provided via a telecommunications system. (B) Eligible telehealth individual The term “eligible telehealth individual” means an individual enrolled under this part who receives a telehealth service furnished at an originating site. (C) Originating site (i) In general Except as provided in paragraphs (5), (6), and (7), the term “originating site” means only those sites described in clause (ii) at which the eligible telehealth individual is located at the time the service is furnished via a telecommunications system and only if such site is located— (I) in an area that is designated as a rural health professional shortage area under section 254e(a)(1)(A) of this title ; (II) in a county that is not included in a Metropolitan Statistical Area; or (III) from an entity that participates in a Federal telemedicine demonstration project that has been approved by (or receives funding from) the Secretary of Health and Human Services as of December 31, 2000 . (ii) Sites described The sites referred to in clause (i) are the following sites: (I) The office of a physician or practitioner. (II) A critical access hospital (as defined in section 1395x(mm)(1) of this title ). (III) A rural health clinic (as defined in section 1395x(aa)(2) of this title ). (IV) A Federally qualified health center (as defined in section 1395x(aa)(4) of this title ). (V) A hospital (as defined in section 1395x(e) of this title ). (VI) A hospital-based or critical access hospital-based renal dialysis center (including satellites). (VII) A skilled nursing facility (as defined in section 1395i–3(a) of this title ). (VIII) A community mental health center (as defined in section 1395x(ff)(3)(B) of this title ). (IX) A renal dialysis facility, but only for purposes of section 1395rr(b)(3)(B) of this title . (X) The home of an individual, but only for purposes of section 1395rr(b)(3)(B) of this title or telehealth services described in paragraph (7). (D) Physician The term “physician” has the meaning given that term in section 1395x(r) of this title . (E) Practitioner The term “practitioner” has the meaning given that term in section 1395u(b)(18)(C) of this title . (F) Telehealth service (i) In general The term “telehealth service” means professional consultations, office visits, and office psychiatry services (identified as of July 1, 2000 , by HCPCS codes 99241–99275, 99201–99215, 90804–90809, and 90862 (and as subsequently modified by the Secretary)), and any additional service specified by the Secretary. (ii) Yearly update The Secretary shall establish a process that provides, on an annual basis, for the addition or deletion of services (and HCPCS codes), as appropriate, to those specified in clause (i) for authorized payment under paragraph (1).

Source

42 USC § 1395m(m)(4)


Scoping language

for purposes of section 1395rr
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